【摘要】 目的探讨血清睾酮(T)水平对提高前列腺癌检出率的临床意义。方法选择2007年4月-2010年4月间在卫生部北京医院及吉林大学第一医院行前列腺6-8针穿刺的患者共75例。穿刺前患者行血清睾酮、PSA检测,直肠指检、前列腺彩超或前列腺MRI检查并测量前列腺体积。病理组织学检查明确前列腺癌的诊断。统计学方法采用单因素多元方差分析及ROC曲线分析。结果前列腺癌患者的血清T水平略低于前列腺增生患者,但无显著差异(P=0.084),ROC曲线分析:血清T水平的ROC曲线下面积为0.617,(P=0.107,95%CI:0.469-0.763),T/PSA的曲线下面积为0.770,(P=0.000,95%CI:0.659-0.881),T/PSAD的曲线下面积为0.858,(P=0.000,95%CI:0.771-0.945),T×PSA-r的曲线下面积为0.800,(P=0.000,95%CI:0.693-0.908)。T/PSA<0.495时,诊断前列腺癌的敏感度为75%,特异度为71%;T/PSAD<21.7时,诊断前列腺癌的敏感度为88%,特异度为71%;T×PSA-r<0.59时,诊断前列腺癌的敏感度为79%,特异度为67%。结论血清睾酮水平对于提高前列腺癌的检出率,增加PSA、PSAD、PSA-r的敏感性及特异性有较为显著的意义,以考虑将血清睾酮水平作为常规前列腺癌筛查的指标。更多还原

【Abstract】 Objective To investigate if the serum testosterone level could improve the detection rate of prostate cancer(PCa).Methods a total of 75 cases who received the first time transrectal ultrasound guide 6-8 cores prostatic biopsy for prostate cancer at the first hospital of Jilin university and Beijing hospital in 2007-2010.Serum testosterone,PSA test,imaging examinations(US or MRI) and pathology examinations were performed.One-way ANOVA and ROC curve statistic analysis were used.Results Serum testosterone levels were slightly different(P=0.084)between BPH and PCa groups.ROC analysis:Area under curve(AUC) of serum testosterone was 0.617(P=0.107,95% CI:0.469-0.763),AUC of T/PSA was 0.770(P=0.000,95% CI:0.659-0.881),AUC of T/PSAD was 0.858(P=0.000,95% CI:0.771-0.945),AUC of T×PSA-r was 0.800(P=0.000,95% CI:0.693-0.908).When T/PSA<0.495,sensitivity is 75%,specificity is 71%.T/PSAD<21.7,sensitivity is 88%,specificity is 71%.T×PSA-r<0.59,sensitivity is 79%,specificity is 67%.Conclusion The level of serum testosterone could improve the detection rate of PCa and increasing the sensitivity and specificity of PSA,PSAD,PSA-r.Serum testosterone could be a routine screening factor for PCa diagnosis.更多还原